Obesity in the developing world can be seen as a
result of a series of changes in diet, physical
activity, health and nutrition, collectively known as the
'nutrition transition.' As poor countries become more
prosperous, they acquire some of the benefits along with
some of the problems of industrialized nations. These
include obesity.

Since urban areas are much further along in the
transition than rural ones, they experience higher rates of
obesity. Cities offer a greater range of food choices,
generally at lower prices. Urban work often demands less
physical exertion than rural work. And as more and more
women work away from home, they may be too busy to shop for,
prepare and cook healthy meals at home. The fact that more
people are moving to the city compounds the problem. In
1900, just 10 percent of the world population inhabited
cities. Today, that figure is nearly 50 percent.

That is not to say that rural areas are immune. Increased
mechanization of farm activity leads to reduced physical
activity at the same time that more food -- but not
necessarily a better variety of foods -- becomes available.
Many rural farmers have given up subsistence farming of
multiple crops that provide a more balanced diet in favour
of a single, high-yielding cash crop.

Importing poor eating habitsAnother element of the nutrition transition is the
increasing importation of foods from the industrialized
world. As a result, traditional diets featuring grains and
vegetables are giving way to meals high in fat and
sugar.

Some critics blame industrialized countries for producing
leaner cuts of meat for their own citizens but selling the
high-fat remainders elsewhere. Turkey tails and mutton flaps
(cuts of skin, fat and little meat) are sold to the
developing world, for instance, despite the fact that 80
percent of the energy in these items come from fat.

Cities--with their greater
choice of food and less active lifestyle--are
increasingly home to obesity. A woman shops in a
market in Turkey.
(FAO/22457/R. Messori)

And as food companies watch incomes rise in the developing
world, they are setting their sights on new markets. From
Mexico to Morocco, the same foods that jeopardize health in
wealthy countries are now tempting poor ones.

Other dietary changes are taking place regardless of
outside influences. In China, when per capita income grew
fourfold after the economic reforms of the late 1970s, the
consumption of high-fat foods soared. And while incomes
grew, the income needed to purchase a fatty diet decreased.
In 1962, a diet containing 20 percent of total energy from
fat correlated with a per capita GNP of US$1 475. By
1990, a GNP of just $750 correlated with the same diet.

In a number of countries, globalization has changed the
face of obesity. In Mexico and Brazil, for example, where
overweight used to be a sign of wealth, it now often marks
poverty. The increased availability of foods at lower prices
mean the poor have access to a richer diet. While the elite
can choose to adopt a healthy lifestyle, the poor have fewer
food choices and more limited access to nutrition
education.

The cost of a poor diet
The underweight and overweight share high levels of sickness
and disability, shortened life spans and reduced
productivity. Obesity increases the risk of chronic diseases
such as diabetes, hypertension, heart disease, stroke, gall
bladder disease and a number of cancers.

And the developing world risks suffering the lion's share
of the growing disease burden. For instance, the number of
people with obesity-related diabetes is expected to double
to 300 million between 1998 and 2025 -- with three-quarters
of that growth projected in the developing world.

For nations whose economic and social resources are
already stretched to the limit, the result could be
disastrous.